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The document titled "CONSTITUTION AND BY-LAWS" is from the Transactions of the American Clinical and Climatological Association, an organization founded in 1884 to improve medical education, research, and practice in the United States. Initially focused on tuberculosis, the Association now covers all aspects of medicine, including the impact of climate change on health. The document outlines the membership criteria, officer roles, and responsibilities of the Council. It also discusses committees, funds, awards, and the involvement of spouses in association activities. The document provides information on the submission and ownership of papers presented at the annual meeting, as well as the process for amending the constitution and by-laws. [Extracted from the article]

The text is a report on the 135th meeting of the American Clinical and Climatological Association (ACCA) held in Sarasota, Florida. The report covers various activities and events that took place during the meeting, including visits to local attractions, paper presentations by provisional members, and the announcement of awards. It also includes financial statements and updates on the organization's portfolio. The report concludes with minutes from the council meeting, which discuss topics such as nominations for new officers, member deaths, and terminations for non-compliance. The text provides information about the attendance and membership status of individuals at the meeting, including those who registered to attend and those who submitted letters of resignation. It also mentions the delinquent payment of dues by certain members and the potential termination of their membership. The report further includes details about the transfer of members to emeritus status based on age and years of active membership. Lastly, it mentions the organization's financial statements and provides information on upcoming meeting dates and locations. [Extracted from the article]

Philip Y. Paterson, MD, was a neuroimmunologist who made significant contributions to the understanding of illnesses such as multiple sclerosis. He died in 2008 at the age of 83 due to cancer. Dr. Paterson promoted the experimental allergic encephalomyelitis (EAE) animal model, which became controversial for studying neuroimmunological disorders. He conducted experiments involving myelin basic protein (MBP) and discovered autoantibodies directed against self-antigens that protected against specific diseases. Dr. Paterson authored numerous papers and coauthored a textbook on infectious diseases. He trained future leaders in neuroimmunology and received several honors for his work. After retirement, he engaged in church activities, community orchestras, and creative writing. [Extracted from the article]

The article offers information on the Mary Allen Engle Award given by the American Clinical and Climatological Association in the U.S. It mentions that the award was conceived in 1999 and is given to any member of the association who presents a paper the year before and who submitted a completed manuscript and returns the edited transcribed version promptly and efficiently. It adds that L. David Hills was the first recipient of the award for his manuscript.

Despite decreases in overall stroke incidence and mortality in the United States, racial and ethnic disparities continue unabated. Of note, the longstanding disproportionate burden of stroke on African Americans compared to other racial and ethnic groups persists, and national projections indicate this toll will likely worsen over the next decade. Why have we not been able to bend the stroke disparities curve for African Americans? Well, this is mainly because traditional stroke risk factors, such as hypertension, diabetes, etc., account for just half of the Black vs. non-Hispanic White stroke disparity. As such, there is increasing interest in evaluating understudied factors like upstream social determinants of health, including geography, psychosocial stress, and environmental pollution; identifying potential mediators; and testing multilevel interventions to address them. This paper highlights emerging avenues that may help decode the excess stroke risk in African Americans, focusing on zip codes, color codes, and epigenetic codes. [ABSTRACT FROM AUTHOR]

In this paper, I will discuss recent studies using a cystic fibrosis pig model to better understand the origins of cystic fibrosis lung disease. Specifically, I will review our work investigating how loss of the cystic fibrosis transmembrane conductance regulator function (CFTR) impairs mucociliary transport in the cystic fibrosis airway. These studies reveal new insights into the early, underlying mechanisms of cystic fibrosis lung disease and could lead to novel therapeutic interventions. [ABSTRACT FROM AUTHOR]

The article focuses on the rules and regulations governing the American Clinical and Climatological Association, founded by a group of physicians and scientists in 1884. Article II refers to the mission of the association to improve medical research and education in the U.S. Article IV describes the number of honorary, provisional, active, and emeritus, and members which should be less than 250.

Dr. James T. Willerson, a renowned cardiologist and researcher, passed away in 2020 after a battle with cancer. His contributions to cardiovascular medicine were significant, and he had a lasting impact on the field. Dr. Willerson was known for his dedication to his patients and his ability to impart clinical skills to medical students. He published over 1,000 peer-reviewed papers and was involved in stem cell research. Dr. Willerson received numerous awards for his work and was highly respected for his scientific rigor and personal touch in his interactions. [Extracted from the article]

The given document is the Recorder's Report for the 135th Meeting of the American Clinical and Climatological Association, held at the Ritz-Carlton Hotel in Sarasota, Florida from October 19th to October 22nd, 2023. The report highlights the work of new members and invited speakers, as well as the editing and review of manuscripts by Dr. Daniel Goodenberger. It also mentions the need for tributes to members who have passed away and suggests providing CVs and photographs for future memorials. The report announces the winners of the Mary Allen Engle Award and the Theodore E. Woodward Award, and mentions a hotel equipment malfunction that prevented the recording of questions and answers for certain papers. It also mentions the publication of a history of the association and acknowledges the editorial efforts of JoAnne Aguiar and the assistance of Teresa Gadouas and Erin Tilley. The report concludes by mentioning the upcoming meeting in Ponte Vedra, Florida and expressing anticipation for meeting old and new friends. [Extracted from the article]

The article focuses on medical society, American Clinical and Climatological Association. Topics include that it was organized in 1884 by a group of physicians and scientists who set about to improve medical education, research and practice; and its initial concern was with tuberculosis and its treatment by residence in a suitable climate.

Information about several papers discussed at the 129th meeting of the Climatological held at the Omni Homestead Resort in Hot Springs, Virginia on October 20-23, 2016, is presented. Topics discussed include the extraordinary price increases in the biopharmaceutical industry, role of pharmacology in medical and patient education and the costs of drug development. The event featured notable speakers which include Tom McLellan, David Dale and Robert Doherty.

Heinrich Stern, a German immigrant, attended medical school in the United States, established a practice in Manhattan, and became a prominent clinician, an influential scholar, a medical journal founder and editor, and the founder of a number of medical organizations, including the American College of Physicians. He was said to be a prolific author, but there has been no prior systematic review of his publications. All known primary publications are reviewed and placed in the context of the medical milieu of his time. [ABSTRACT FROM AUTHOR]

Washington University School of Medicine has not undergone substantive curricular change for 25 years. In 2018, we embarked on a curriculum transformation project informed by the change leadership principles of James Kotter and William Bridges. This included developing a structured process to create a sense of urgency for why we needed to change, building coalitions to support change, and developing a compelling vision across multiple stakeholder groups. Implementation work began in 2019 with a planned curriculum start of July 2020. The COVID-19 pandemic disrupted these plans. Employing the Cynefin framework for decision making and guided by our core principles, we were able to launch the new curriculum in September 2020. In this paper, I will describe the principles underpinning our curriculum transformation, how the Cynefin framework allowed us to move forward productively during the COVID-19 crisis, and the impact COVID-19 had, both positively and negatively, on the curriculum transformation process. [ABSTRACT FROM AUTHOR]

The article offers information on the 131th meeting of the Climatological which was held at the Ritz-Carlton hotel in Sarasota, Florida. Topics discussed include papers presented by the provisional members; income investment and transfer of monies within fund classes; and presentation of Harvey Alter, the Chief of Clinical Studies and Associate Director for Research at National Institutes of Health Hospital in Bethesda, Maryland, on Hepatitis C: From Hippocrates to Cure.

The article present constitution and by-laws of the American Clinical and Climatological Association, a group of physicians and scientists. Topics include improving medical education, research and practice; scientific and clinical aspects of medicine and its specialties as well as epidemiology, preventive and environmental medicine; and making of distributions to organizations that qualify as exempt organizations under the corresponding provisions of any future U.S. Internal Revenue Law.

The article focuses on constitutions and by-laws of the American Clinical and Climatological Association, a group of physicians and scientists who set about to improve medical education, research and practice. Topics include scientific and clinical aspects of medicine and its specialties as well as epidemiology, preventive and environmental medicine; retaining a continuing interest in the influence of global climate changes on health and disease; and nominations of officers & council members.

This paper first introduces important conceptual and practical distinctions among three key terms: substance "use," "misuse," and "disorders" (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach. [ABSTRACT FROM AUTHOR]

Dr. Chi-yuan Hsu describes controversies surrounding the race coefficient ("if African American") in widely used kidney function estimating equations. He outlines recent research results on this topic by himself and others and comments on the relationship between activists and the academic medical community. [ABSTRACT FROM AUTHOR]

The article focuses on the history of virology as seen through the American Clinical and Climatological Association (ACCA). Topics include the association's incorporation of virology, major virology topics discussed at ACCA meetings such as HIV and SARS CoV2, and the early discoveries and developments in virology, including the first identification of viruses in plants and animals.

The article offers information on the by-laws and constitution of the American Clinical and Climatological Association. Topics discussed include membership, nominations, elections and duties of officers, and committees. Among the committees are finance committee, membership committee, and audit committee.

The article offers the author's insights on the appreciation for the contribution of Secretary-Treasurer Richard Lange and his wife Bobette to the American Clinical and Climatological Association. Topics include the history of climatological meetings in Ponte Vedra, Florida, the effects of aspirin for the prolongation of the bleeding time, and the importance of climate in the treatment of disease.

The article presents information on the constitution and by-laws of the American Clinical and Climatological Association (ACCA). The ACCA was organized in 1884 by a group of physicians and scientists to improve medical education, research and practice in the U.S. ACCA is an exempt organizations under Section 501(c) (3) of the Internal Revenue Code.

We are presently seeing exponential advances in medical knowledge and development of therapeutic and diagnostic tools. We have also begun to experience an historic restructuring of our health care system. But health care costs continue to rise, disparities persist, and the chaotic, disjointed, and often thoughtless discourse in Washington threatens to roll back the prior advances. Improvement in patient care will be severely stymied if the threats to academic medical centers are not countered. This paper will explore our present state through the lens of cardiovascular care. It will 1) examine clinical trends; 2) dissect the value and challenges to the Patient Protection and Affordable Care Act; 3) highlight limitations and alternatives to relying on the federal government; and 4) present the Academic Medical System construct, as a structure designed to retain and advance the academic mission. [ABSTRACT FROM AUTHOR]

The article focuses on the American Clinical & Climatological Association's 133rd Meeting held during March 24-27, 2022 in Charleston, South Carolina. Topic discussed include the history of cholera pandemic by the association's president Glenn Morris, the need to address racial and ethnic disparities to combat COVID-19 globally, and the history of the rare Bald Eagle bird.

This paper analyzes four trends that are affecting the 2016 election: changing US demographics and the reaction to them, a growing distrust of government, increased polarization and government gridlock, and the rise of populism. It compares the views of candidates Hillary Rodham Clinton and Donald S. Trump on the Affordable Care Act, climate change, prescription drug pricing, prevention of injuries and deaths from firearms, and the opioids epidemic; and offers perspectives on the potential impact of the election not only on U.S. health care policy, but on the health of American democracy itself. [ABSTRACT FROM AUTHOR]

Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey -- one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change. [ABSTRACT FROM AUTHOR]

Given the high costs of producing a medical journal, the need to publish clinically relevant information, and the fact that many journals can publish only a small fraction of the many scientific papers they consider, it seems reasonable to wonder whether stories deserve a place in a scholarly medical journal. Using examples from Annals of Internal Medicine, this commentary discusses the important role stories can serve in scholarly medical journals. [ABSTRACT FROM AUTHOR]

The article offers information on life and career of Harry W Fritts Jr., the first Chair of the Department of Medicine at the Stony Brook University School of Medicine in Stony Brook, New York. Topics discussed include he fought in the Second Battle of the Philippine Sea; his broad interest in medicine and the academic world; and also mentions about Dr. Fritts' book, "On Leading a Clinical Department" published by the Johns Hopkins University Press.

The article focuses on the Mary Allen Engle Award, which is presented annually to a member of the association who efficiently submits a completed manuscript based on their presentation from the previous year. The award was created to recognize diligence in manuscript submission and encourage timely publishing of the Transactions and Mary Allen Engle, the award's namesake, played a significant role in the field of Pediatric Cardiology, published extensively.

With rapid changes in health care and academic medicine, deans and medical educators need to carefully optimize medical education in order to best prepare our students for the future. Fundamentally, it is critical that future medical practitioners develop curious minds that look beyond the obvious to ask questions not yet asked and glean reality. This paper summarizes optimal adult learning, including (for example) concepts such as deliberate practice, active and interactive learning, and the flipped classroom. [ABSTRACT FROM AUTHOR]

The structure and function of departments of medicine are important for several reasons. First, departments of medicine are the biggest departments in virtually every medical school and in most universities with a medical school, and they are the largest professional units in most academic medical centers. In fact, Petersdorf described them as "the linchpins of medical schools" (1). Departments of medicine account for one-fourth or more of the academic medical enterprise: they include about one-fourth of the faculty of medical school, account for roughly one-fourth of the patient care and clinical revenue of academic medical centers, and their faculty perform a disproportionate share of teaching and research, accounting for up to 45% of National Institutes of Health (NIH) - funded research in some medical schools. Second, the department's ability to fulfill its role and advance its mission depends on its structure and function. Finally, lessons learned from examining the structure and function of departments of medicine may guide other departments and schools of medicine themselves in improving their structure and function. This paper describes the issues that face departments of medicine in 2016. I begin by providing the context for these issues with a definition of a department of medicine, describing briefly the history of departments, and stating their mission. [ABSTRACT FROM AUTHOR]

The article offers information on life and career of J. Vernon Knight, Emeritus Professor and Chair of the Department of Microbiology and Immunology at Baylor College of Medicine in Houston, Texas. Topics include he participated in the first use of penicillin to determine whether it would be useful in treating infections in the military; he published more than 500 scientific papers and a medical school textbook on respiratory tract infections; and his believed in the value of personal fitness.

The article discusses life & career of Dr. Sherman Mellinkoff, dean of the University of California, Los Angeles (UCLA) School of Medicine for 24 years. Topics include his early interest in liver disease and writing on a variety of topics such as carbohydrate metabolism, medical education and the responsibilities of medicine; under his leadership a comprehensive cancer center opened at the school; and Sherman Mellinkoff Faculty Award for doctor-patient relationships and medical education.

The conquest of pellagra is commonly associated with one name: Joseph Goldberger of the US Public Health Service, who in 1914 went south, concluded within 4 months that the cause was inadequate diet, spent the rest of his life researching the disease, and-before his death from cancer in 1929-found that brewer's yeast could prevent and treat it at nominal cost. It does Goldberger no discredit to emphasize that between 1907 and 1914 a patchwork coalition of asylum superintendents, practicing physicians, local health officials, and others established for the first time an English-language competence in pellagra, sifted through competing hypotheses, and narrowed the choices down to two: an insect-borne infection hypothesis, championed by the flamboyant European Louis Westerna Sambon, and the new "vitamine hypothesis," proffered by Casimir Funk in early 1912 and articulated later that year by two members of the American Clinical and Climatological Association, Fleming Mant Sandwith and Rupert Blue. Those who resisted Goldberger's inconvenient truth that the root cause was southern poverty drew their arguments largely from the Thompson-McFadden Pellagra Commission, which traces back to Sambon's unfortunate influence on American researchers. Thousands died as a result. [ABSTRACT FROM AUTHOR]

The article reports the 132nd business meeting of The Climatological held from October 17 to October 20, 2019 at Grand Hotel Resort and Spa in Point Clear, Alabama. Topics include that the names of recently deceased members were shared, followed by a moment of silence to honor them; financial statements were presented; and that Nominating Committee's recommendations for new officers and Councilors were presented along with awardee names.

Despite higher per-capita health care spending than any other country, the United States lags far behind in health outcomes. Additionally, there are significant health inequities by race, ethnicity, socioeconomic position, and rurality. One set of potential solutions to improve these outcomes and reduce inequities is through health policy. Policy focused on improving access to care through insurance coverage, such as the Affordable Care Act's Medicaid expansion, has led to better health and reduced mortality. Policy aimed at improving health care delivery, including value-based payment and alternative payment models, has improved quality of care but has had little impact on population health outcomes. Policies that influence broader issues of economic opportunity likely have a strong influence on health, but lack the evidence base of more targeted interventions. To advance health outcomes and equity, further policy change is crucial. [ABSTRACT FROM AUTHOR]

This document provides an overview of world events and advancements in clinical medicine during the first quarter of the American Clinical & Climatological Association's second century. It covers significant events such as the end of the Cold War, the reunification of Germany, and major terrorist attacks. In terms of clinical medicine, advancements like the polymerase chain reaction (PCR), the use of stents in angioplasty, and the derivation of human embryonic stem cells are highlighted. The implementation of telesurgery and the development of preventive medicine, including the use of statins and the introduction of new vaccines, are also discussed. Challenges during this period included drug-resistant tuberculosis, mad cow disease, and outbreaks of SARS, MERS, and COVID-19. [Extracted from the article]

The text provides summaries of various annual meetings of the American Clinical & Climatological Association (ACCA) from different years. The meetings covered a wide range of medical topics, including healthcare for the poor, alcoholism, travel medicine, hospice care, and genetic engineering. Presentations also addressed issues such as declining medical school applicants, sleep for interns, and the impact of Hurricane Katrina. The meetings emphasized the importance of diversity and inclusion in the medical field and included discussions on climate change and health. The ACCA also addressed business matters and recognized outstanding contributions to the field. [Extracted from the article]

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. VTE is caused by genetic and acquired conditions, but the genetic variants that increase the risk of VTE are not fully characterized. Recent genome-wide association studies (GWAS) have discovered novel genetic loci linked to VTE. Some of these loci have been characterized, uncovering new pathways that regulate VTE. Functional characterization of candidate genes discovered by GWAS may reveal new therapeutic targets to treat and prevent abnormal thrombosis or bleeding. [ABSTRACT FROM AUTHOR]

Gene-environmental interactions create risk profiles for sporadic cancer development in patients with colorectal cancer (CRC). For instance, a person's socioeconomic status over their lifetime can affect their level of physical activity and type of diet, and their exposure to tobacco and alcohol may affect their gut microbiome and ultimate risk for developing CRC. Metabolic disease can independently or further change the gut microbiome and alter the typical timing of CRC development, such as is observed and linked with early-onset disease. Patients with microsatellite unstable tumors where DNA mismatch repair is defective have altered immune environments as a result of tumor hypermutability and neoantigen generation, allowing for immune checkpoint inhibitor susceptibility; in such cases, the genetics of the tumor changed the environment. The environment can also change the genetics, where interleukin-6-generated inflammation can inactivate MSH3 protein function that is associated with CRCs which are more metastatic, and patients show poor outcomes. Some specific aspects of the local microbial environment that may be influenced by diet and metabolism are associated with CRC risk, such as Fusobacterium nucleatum infection, and may affect the initiation, perpetuation, and spread of CRC. Overall, both the macro- and microenvironments associated with a person play a major role in CRC formation, progression, and metastases. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) in the form of ChatGPT has rapidly attracted attention from physicians and medical educators. While it holds great promise for more routine medical tasks, may broaden one's differential diagnosis, and may be able to assist in the evaluation of images, such as radiographs and electrocardiograms, the technology is largely based on advanced algorithms akin to pattern recognition. One of the key questions raised in concert with these advances is: What does the growth of artificial intelligence mean for medical education, particularly the development of critical thinking and clinical reasoning? In this commentary, we will explore the elements of cognitive theory that underlie the ways in which physicians are taught to reason through a diagnostic case and compare hypothetico-deductive reasoning, often employing illness scripts, with inductive reasoning, which is based on a deeper understanding of mechanisms of health and disease. Issues of cognitive bias and their impact on diagnostic error will be examined. The constructs of routine and adaptive expertise will also be delineated. The application of artificial intelligence to diagnostic problem solving, along with concerns about racial and gender bias, will be delineated. Using several case examples, we will demonstrate the limitations of this technology and its potential pitfalls and outline the direction medical education may need to take in the years to come. [ABSTRACT FROM AUTHOR]

Early in the pandemic, clinicians recognized an overlap between Long COVID symptoms and dysautonomia, suggesting autonomic nervous system (ANS) dysfunction. Our clinical experience at Johns Hopkins with primary dysautonomia suggested heritability of sympathetic dysfunction, manifesting primarily as hyperhidrosis and as other dysautonomia symptoms. Whole exome sequencing revealed mutations in genes regulating electrical signaling in the nervous system, thus providing a genetic basis for the sympathetic overdrive observed. We hypothesize that dysautonomia in Long COVID requires two molecular hits: a genetic vulnerability to prime the ANS and a SARS-CoV-2 infection, as an immune trigger, to further disrupt ANS function resulting in increased sympathetic activity. Indeed, Long COVID patients show signs of chronic inflammation and autoimmunity. We have translated this two-hit concept to the clinic using ion channel inhibitors to target genetic susceptibility and immunomodulators to treat inflammation. This multi-hit hypothesis shows promise for managing Long COVID and merits further study. [ABSTRACT FROM AUTHOR]

Housing instability has been shown to negatively impact physical and mental health, with a corresponding increase in health care utilization. In 2019, through a Maryland Medicaid 1115 Health Choice Waiver, 10 Baltimore city hospitals joined with the city of Baltimore and the local nonprofit Health Care for the Homeless to support an innovative program that provides permanent housing and wraparound services to individuals at risk of homelessness. Here, we describe the inception of the program and its subsequent expansion with the investment of the city hospitals. Participants in the program experienced a 48% reduction in all hospital visits and a 51% reduction in emergency department visits in the 12 months following their receipt of housing compared to the 12 months before enrollment. These data suggest the potential health benefits of housing and supportive services as an intervention. [ABSTRACT FROM AUTHOR]

The rapid and unprecedented climate changes driven by human-induced greenhouse gas emissions present a critical challenge for society today. However, the link between climate change and health remains inadequately explored in both literature and policy discussions. Thousands of individuals die each year in the United States due to climate-related factors, including extreme temperatures, severe weather, air pollution, and vector-borne diseases, and these health impacts disproportionately affect already vulnerable populations. Climate change is not just an environmental concern but also an imminent threat to individual and population health, as well as a major challenge to health equity. Moreover, the health sector significantly contributes to greenhouse gas emissions. Recognizing their roles as health care providers and contributors to the climate crisis, clinicians and health professionals have a moral obligation to emphasize the profound significance of climate impacts on human health and equity. This lecture provides an overview of efforts by the U.S. National Academy of Medicine and others to address the intersection of climate change and health, with an aim to raise awareness about the immediate threats to patient health and to build a proactive path forward for the health sector. The health sector must unite to collectively tackle these challenges, safeguard patient well-being, and promote the common good in the face of climate-induced health crises. [ABSTRACT FROM AUTHOR]

This document is a list of references related to the topic of preeclampsia and the use of angiogenic biomarkers for diagnosis and prediction. The references include studies on the role of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) in preeclampsia, as well as their potential use as diagnostic and prognostic markers. The studies mentioned cover various aspects of preeclampsia, including its differentiation from other conditions, prediction of adverse outcomes, and the clinical implementation of angiogenic biomarkers. The document also includes references to real-world studies and the use of angiogenic factors in the management of placental dysfunction. [Extracted from the article]

The author, Dr. A. Wesley Burks, reflects on his life's work to improve the lives of his patients. [ABSTRACT FROM AUTHOR]

This article discusses the history and evolution of the American Clinical & Climatological Association, highlighting its founding in 1884 and changes in its mission and structure over time. It emphasizes the association's commitment to diversity and its focus on climate, environment, and human health. The text also addresses the issue of maternal health disparities in the United States, particularly among Black and Native American women, and the need for culturally appropriate and respectful care. It discusses the lack of diversity in the medical student body and highlights efforts to increase diversity in the healthcare workforce. Ongoing initiatives, such as a $168 million study by the NIH, are mentioned to address the maternal health crisis and improve outcomes for marginalized communities. [Extracted from the article]

This document is a memorial for Randy Cebul, MD, a health services researcher who made significant contributions to medical decision making and healthcare improvement in northeast Ohio. Randy was born in Cleveland in 1950 and attended Denison University and Yale Medical School. He joined the faculty of Case Western Reserve University and became the Chief of General Medicine at MetroHealth Medical Center. Randy was known for his mentorship and commitment to building a pipeline of health services researchers. He also played a key role in creating the Better Health Partnership, a collaborative effort to improve healthcare in the region. Randy's work focused on reducing disparities in healthcare and improving population health outcomes. He published groundbreaking research on individualized decision analysis, electronic health records, and the cost of health insurance. Randy's contributions had a measurable impact on the lives of thousands of people in northeast Ohio. [Extracted from the article]